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腹型肥胖、代谢综合征与乳腺癌患者生存结局的关系。

The Association between Abdominal Obesity, Metabolic Syndrome and Survival Outcomes in Patients with Breast Cancer.

机构信息

Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada; Dr. Sardjito Hospital, Yogyakarta, Indonesia.

Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada; Dr. Sardjito Hospital, Yogyakarta, Indonesia.

出版信息

Asian Pac J Cancer Prev. 2022 Sep 1;23(9):3157-3165. doi: 10.31557/APJCP.2022.23.9.3157.

Abstract

BACKGROUND

Obesity and metabolic syndrome (MetS) have been linked to the risk of developing certain cancers. This study aimed to analyze the association between obesity markers, MetS and survival outcomes of patients with breast cancer.

METHODS

This study retrospectively investigated patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-), nonmetastatic breast cancer diagnosed between January 2010 and December 2019. Data on clinical conditions, body mass index (BMI), waist-to-hip ratio (WHR), MetS, time of metastasis and death were collected.

RESULTS

A total of 223 breast cancer patient records were eligible for analysis. Obesity (BMI ≥ 25) was found in 38.1% of cases. Abdominal obesity measured as WHR ≥ 0.85 was found in 48.9%. Metabolic syndrome was detected in 56.1% of patients and was associated with older age (OR = 2.196, p = 0.005), postmenopausal status (OR = 2.585, p = 0.001), obesity (OR = 5.684, p = 0.001) and abdominal obesity (OR = 2.612, p = 0.001). Obesity was not associated with poor disease-free survival (DFS) or overall survival (OS), while abdominal obesity was modestly associated with poor DFS (HR = 1.539, p = 0.083) and OS (HR = 3.117; p = 0.019). Multivariate analysis revealed that WHR ≥ 0.85 was independently associated with unfavorable DFS (HR = 1.907, p = 0.027). Patients with MetS had a similar survival rate to those with normal metabolism.

CONCLUSION

In Indonesian women with HR+/HER2- breast cancers, obesity and MetS were not associated with poor survival outcomes. The abdominal obesity marker (WHR) was more accurate in predicting unfavorable DFS.

摘要

背景

肥胖和代谢综合征(MetS)与某些癌症的发病风险相关。本研究旨在分析肥胖标志物、MetS 与激素受体阳性、人表皮生长因子受体 2 阴性(HR+/HER2-)、非转移性乳腺癌患者生存结局的关系。

方法

本研究回顾性分析了 2010 年 1 月至 2019 年 12 月期间诊断为 HR+/HER2-、非转移性乳腺癌的患者。收集了临床状况、体重指数(BMI)、腰臀比(WHR)、MetS、转移和死亡时间的数据。

结果

共有 223 例乳腺癌患者的记录符合分析条件。肥胖(BMI≥25)占 38.1%。腹部肥胖(WHR≥0.85)占 48.9%。56.1%的患者存在代谢综合征,且与年龄较大(OR=2.196,p=0.005)、绝经后状态(OR=2.585,p=0.001)、肥胖(OR=5.684,p=0.001)和腹部肥胖(OR=2.612,p=0.001)相关。肥胖与无病生存期(DFS)或总生存期(OS)不良无关,而腹部肥胖与 DFS(HR=1.539,p=0.083)和 OS(HR=3.117;p=0.019)不良相关。多变量分析显示,WHR≥0.85 与不良 DFS 独立相关(HR=1.907,p=0.027)。患有 MetS 的患者与代谢正常的患者的生存率相似。

结论

在印度尼西亚 HR+/HER2-乳腺癌患者中,肥胖和 MetS 与不良生存结局无关。腹部肥胖标志物(WHR)更能准确预测不良 DFS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bede/9810288/4ae5e366b7dd/APJCP-23-3157-g001.jpg

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